Provider Demographics
NPI:1407242217
Name:ADRIANO, MARIA ANDREA GABRIEL
Entity Type:Individual
Prefix:
First Name:MARIA ANDREA
Middle Name:GABRIEL
Last Name:ADRIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14014 MARSH PIKE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1638
Mailing Address - Country:US
Mailing Address - Phone:301-864-2333
Mailing Address - Fax:
Practice Address - Street 1:14014 MARSH PIKE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-1638
Practice Address - Country:US
Practice Address - Phone:301-864-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07452OtherMARYLAND BOARD OF OCCUPATIONAL THERAPY